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经导管主动脉瓣植入术患者的生活质量:来自INTERVENT项目的分析。

Quality of life in patients with transcatheter aortic valve implantation: an analysis from the INTERVENT project.

作者信息

Tamm Alexander R, Jobst Marina L, Geyer Martin, Hahad Omar, Buderus Victoria, Schmidt Alexander, Prochaska Jürgen H, Wild Philipp S, Treede Hendrik, Münzel Thomas, von Bardeleben Ralph Stephan

机构信息

Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany.

Department of Cardiology, Preventive Cardiology and Preventive Medicine, University Medical Center Mainz, Mainz, Germany.

出版信息

Front Cardiovasc Med. 2023 Jun 26;10:1181771. doi: 10.3389/fcvm.2023.1181771. eCollection 2023.

Abstract

BACKGROUND

Transcatheter aortic valve implantation (TAVI) is a standard treatment for patients with aortic valve stenosis due to its very low mortality and complication rates. However, survival and physical integrity are not the only important factors. Quality of life (QoL) improvement is a crucial part in the evaluation of therapy success.

METHODS

Patients with TAVI were questioned about their QoL before, one month and one year after the intervention as part of the INTERVENT registry trial at Mainz University Medical Center. Three different questionnaires were included in the data collection (Katz ADL, EQ-5D-5l, PHQ-D).

RESULTS

We included 285 TAVI patients in the analysis (mean age 79.8 years, 59.4% male, mean EuroSCORE II 3.8%). 30-day mortality was 3.6%, complications of any kind occurred in 18.9% of the patients. Main finding was a significant increase in the general state of health measured on the visual analog scale by an average of 4.53 (± 23.58) points (BL to 1-month follow-up,  = 0.009) and by 5.19 (± 23.64) points (BL to 12-month follow-up,  = 0.016). There was also an improvement of depression symptoms, which was reflected in a decrease in the total value of the PHQ-D by 1.67 (± 4.75) points (BL to 12-month follow-up,  = 0.001). The evaluation of the EQ-5D-5l showed a significant improvement in mobility after one month (M = -0.41 (± 1.31),  < 0.001. Regarding the independence of the patients, no significant difference could be found. Apart from that, patients with risk factors, comorbidities or complications also benefited from the intervention despite their poor starting position.

CONCLUSION

We could show an early benefit of QoL in TAVI patients with significant improvement in the subjective state of health and a decrease in symptoms of depression. These findings were consistent over 1 year of follow up.

摘要

背景

经导管主动脉瓣植入术(TAVI)因其极低的死亡率和并发症发生率,已成为主动脉瓣狭窄患者的标准治疗方法。然而,生存和身体完整性并非唯一重要因素。生活质量(QoL)的改善是评估治疗成功与否的关键部分。

方法

作为美因茨大学医学中心INTERVENT注册试验的一部分,对接受TAVI治疗的患者在干预前、干预后1个月和1年时的生活质量进行了询问。数据收集过程中纳入了三种不同的问卷(Katz日常生活活动能力量表、EQ-5D-5L量表、PHQ-D量表)。

结果

我们纳入了285例接受TAVI治疗的患者进行分析(平均年龄79.8岁,男性占59.4%,平均欧洲心脏手术风险评估系统II评分为3.8%)。30天死亡率为3.6%,18.9%的患者出现了任何类型的并发症。主要发现是,通过视觉模拟量表测量的总体健康状况显著改善,平均提高了4.53(±23.58)分(基线至1个月随访,P = 0.009),以及提高了5.19(±23.64)分(基线至12个月随访,P = 0.016)。抑郁症状也有所改善,这体现在PHQ-D量表总分下降了1.67(±4.75)分(基线至12个月随访,P = 0.001)。EQ-5D-5L量表评估显示,1个月后活动能力有显著改善(M = -0.41(±1.31),P < 0.001)。关于患者的独立性,未发现显著差异。除此之外,尽管存在危险因素、合并症或并发症的患者起始状况较差,但他们也从干预中获益。

结论

我们发现TAVI患者的生活质量在早期就有改善,主观健康状况显著提高,抑郁症状减轻。这些发现经过1年的随访保持一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5e9/10330696/510a759e9791/fcvm-10-1181771-g002.jpg

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